Wednesday, March 27, 2013

7 year old's episodic outbursts at school and school

Hello Dr. Gottlieb:
My wife and I came across your article yesterday on "Anger Overload" in an attempt to understand an anger management issue we are experiencing with our youngest son who is age seven. We have experienced, for some time, anger management issues with Nick and have taken him to a child psychologist in the area we live in. Unfortunately when we took Nick to talk to the therapist he refused to speak. The psychologist told us at this point that it doesn't make sense to continue to bring him to her since he will not talk to her or engage with her in any way.

This past week  his elementary school called us three times due to his anger related behavior. The last call came on Friday when he was in the Principal's office banging desks and kicking a window in an adjoining office. When my wife and I arrived we were told that he became upset while in his homeroom and it escalated to a gym class shortly afterward. He was asked to get in line with the other students in gym but repeatly refused and became disruptive to the point where the teacher sent him to the principal's office. As mentioned, in the principal's office he was banging desks and kicking a window in the office area.

We spent considerable time shortly after the events on Friday ascertaining my son and  the rationale for his behavior. His class was having a party at the end of the day and he was looking forward to attending. When he realized that his gym teacher had sent him to the office he became enraged to think that he wasn't going to be able to attend the party. We asked Nick what he was thinking while in the principal's office and he said that his head was telling him to to bang the windows.

My wife found your article early Saturday morning after a sleepless night searching for something on the internet to assist us. She read to me your article on Anger Overload and it was as if you were describing our son. Our intent is to meet with the school staff to discuss suggestions/thoughts on recognizing potential anger outbursts in advance and develop interventions to prevent an anger overload.

 One suggestion we discussed with our son yesterday was to bring to school a picture of his dog and look at it once he feels he is getting mad to prevent him from going to an anger outburst. Another suggestion we are interested in trying is the use of "play therapy" that was suggested by both the school psychologist was well as social worker. We are waiting to schedule such therapy the coming week and see if this is effective. We are also planning to discuss telling our son that he will be rewarded for "good days" where we are not told of an anger outburst situation. Like any other seven year old he enjoys buying toys/games with his own money once is has saved enought to do so.  

Nick is a very bright loving child at home 90% of the time but does have episodes where he could be described as in Anger Overload. I truly believe, from his feedback to us, that he doesn't like feeling out of control with his anger and wants help.Unfortunately, he tends to shut down when we try and discuss what he could do differently.   As mentioned earlier it can be a challenge for him to open up about his feelings and thoughts following an outburst event. We want more than anything for him to be happy.  I would greatly welcome any thoughts/ suggestions you may have and be willing to answer any questions you may have.

Hi, You are on the right track when you mentioned that you would meet with the school and work together to pick up early signs of anger and find alternatives that are workable in your school.  If the adults together can pick up early signs that your son is frustrated or angry, then your interventions are more likely to work.   Also, by brainstorming together with your son's teachers, you can develop a plan that everyone can get behind.  

In my book, I explain how it is important first to keep a written record of what precedes a child's outbursts.  What patterns do you see?  Does your child think he is going to miss out (like with the class party you mention)?  Does that kind of situation lead to  him getting angry sometimes?  What happened in the homeroom before gym that started him on the road to anger overload?  If you see a few patterns, you and the teachers will better be able to anticipate your son's anger and distract him before he gets to the overload phase.

 Rewards sometimes help, but sometimes not.  Sometimes children get so angry so quickly that they do not think about rewards and consequences at the time.  Whether you use rewards or just talk about alternatives for expressing anger appropriately in school, I would use words like "self-control" to describe the goal for your child, and then give him examples of what he can do when he gets upset that would show self-control.   You would only do this while your child is calm, not in the midst of a meltdown.  If your child does not want to talk about his anger yet, then you and the teachers can still try to anticipate outbursts, and use distraction and calming strategies (I like your idea of his looking at the picture of his dog, as the picture may help soothe him) that I describe in the first half of my book.

At some point your child may be ready to work on the causes with you.  Eventually you would try to help him look at situations from another perspective and help him think through what to do.  The second half of my workbook explains how to help him recognize early signs of anger, and how to look at things from another perspective before he gets overwhelmed with emotion.
I encourage parents to teach their children "catch phrases" to help them remember to look at things in a new way.  For example, for a child who gets angry when an adult does not respond right away, you could teach the child to say to himself  "she still cares about me, she is just busy now,"  or "she will help if I wait."  Or if the child feels the adult is depriving him of something, the catch phrase could be "Maybe Mom or Dad have a different way of looking at this, they are not trying to be mean to me."   You would work on the catch phrase with your child and pick words that everyone agrees are meaningful to your child's situation.

All the best, Dr. Dave Gottlieb

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